Recurrent Atrial Fibrillation with Isolated Pulmonary Veins: What to Do

Carola Gianni, Alisara Anannab, Domenico G. Della Rocca, Anu Salwan, Bryan MacDonald, Angel Quintero Mayedo, Sanghamitra Mohanty, Chintan Trivedi, Luigi Di Biase, Andrea Natale

Research output: Contribution to journalReview article


When patients have symptomatic recurrent atrial tachyarrhythmias after 2 months following pulmonary vein antral isolation, a repeat ablation should be considered. Patients might present with isolated pulmonary veins posterior wall. In these patients, posterior wall isolation is extended, and non-pulmonary vein triggers are actively sought and ablated. Moreover, in those with non-paroxysmal atrial fibrillation or a known higher prevalence of non-pulmonary vein triggers, empirical isolation of the superior vena cava, coronary sinus, and/or left atrial appendage might be performed. In this review, we will focus on ablation of non-pulmonary vein triggers, summarizing our current approach for their mapping and ablation.

Original languageEnglish (US)
Pages (from-to)209-217
Number of pages9
JournalCardiac Electrophysiology Clinics
Issue number2
StatePublished - Jun 2020


  • Atrial fibrillation ablation
  • Coronary sinus
  • Left atrial appendage
  • Left atrial posterior wall
  • Nonpulmonary vein triggers
  • Superior vena cava

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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  • Cite this

    Gianni, C., Anannab, A., Della Rocca, D. G., Salwan, A., MacDonald, B., Mayedo, A. Q., Mohanty, S., Trivedi, C., Di Biase, L., & Natale, A. (2020). Recurrent Atrial Fibrillation with Isolated Pulmonary Veins: What to Do. Cardiac Electrophysiology Clinics, 12(2), 209-217.